Delayed Slipped Capital Femoral Epiphysis Following Septic Arthritis of a Hip: A Case Report

INTRODUCTION: Delayed slip of the capital femoral epiphysis is a rare entity in the setting of a septic hip. CASE REPORT: A 13-year-old male presented with an inability to walk and pain around right hip and knee region with fever. On imaging evaluation, a diagnosis of septic hip and knee arthritis was made and both the joints were drained under general anesthesia by anterior approach and an empirical antibiotic therapy was started. On the initial radiograph, there was no sign of slippage of the capital femoral epiphysis. Although the limb was kept in an immobilized position in the 1st week of the surgical debridement, yet it did not prevent the subsequent development of slipped capital femoral epiphysis (SCFE). Open reduction and screw fixation was done to stabilize the slippage. Healing took place with reduction of joint space with some restriction of the hip motion. CONCLUSION: SCFE is a disastrous complication in association with septic arthritis of a hip. Routine traction and immobilization may not prevent slippage. Disproportionate amount of pain on weight bearing in a post septic hip should raise the suspicion of SCFE. Prophylactic pinning may be considered in selective cases with antibiotic coverage.